Facility Evaluation Report

On May 15, 2025, Licensing Program Analyst (LPA) Kiran Jain arrived unannounced at the facility to conduct a Case Management – Other inspection for a facility closure visit, initiated by the Licensee. Upon arrival, the LPA met with family member of the licensee, Mae Sampani. The licensee, Marina Sampani was out of the country. LPA disclosed the purpose of the visit.

LPA conducted a walk-through of the facility and inspected all rooms and common areas.

The FM stated that they planned to continue caring for one (1) resident (R1) following the facility’s closure, per the request of R1’s family. The FM explained that they would care for R1 as a family friend, as they were very close to R1 and R1’s family. R1 had lived with the licensee for 25 years. R1’s Power of Attorney (POA) did not want R1 to move out of the home, given the long-term residence. R1’s sister also asked the licensee to continue providing care after the facility’s closure. R1 was conserved, and the conservator supported R1’s continued residence in the home.

LPA learned that R1’s social worker visited the facility at least once per month but could visit more frequently as there were no restrictions on visit frequency. R1 received care through the Veterans Affairs (VA), and a VA nurse visited the facility every two weeks to monitor medications and conduct body checks. The FM stated they would continue assisting with R1’s medication administration after closure. The FM reported that R1 was independent and able to perform all activities of daily living, including dressing, grooming, bathing, and toileting. R1 continued to attend a day program Monday through Friday and returned home in the evenings.

Aside from R1, there were no other residents currently living in the facility. The FM stated that resident and staff records would be retained in storage for three years.